Epidemiological characteristics and outcome in elderly patients sustaining non‐simultaneous bilateral hip fracture: A systematic review and meta‐analysis

Objectives The present study aimed to quantitatively and comprehensively conclude the epidemiological characteristics and outcome in elderly patients with non‐simultaneous bilateral hip fractures. Methods A search was applied to M edline, E mbase and Cochrane central database (all up to F ebruary 2014). All the studies on non‐simultaneous bilateral hip fractures in elderly patients without language restriction were reviewed, and qualities of included studies were assessed using the N ewcastle– O ttawa S cale. All the data were carefully and independently abstracted by two reviewers, any disagreement was settled by discussion. Data were pooled and a meta‐analysis completed. Results A total of 23 studies (all were observational) including 2168 cases with bilateral hip fractures were identified, showing an accumulated incidence of 8.54%, and of them 71.4% were symmetrical. A total of 70.4% of cases occurred in the first 3 years, especially 36.3% in the first year. Results of meta‐analyses showed that patients of female sex (odds ratio [ OR ] 1.48, 95% confidence interval [ CI ] 1.10–1.99), advanced age (standardized mean difference 0.25, 95% CI 0.15–0.36), initial trochanteric fractures ( OR 1.15, 95% CI 1.01–1.32) and osteoporosis ( S ingh I ndex 1–3) ( OR 10.02, 95% CI 5.41–18.57) were more likely to sustain a second contralateral hip fracture. Conclusions Non‐simultaneous bilateral hip fracture accounts for a high proportion of hip fractures, and most of the second hip fractures occurred in the first 3 years. Patients of female sex, having initial trochanteric fractures, of more advanced age and having osteoporosis are more likely to sustain a second contralateral hip fracture, and risk‐reduction strategies should be implemented. Geriatr Gerontol Int 2015; 15: 11–18.